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Individual
STACY UNDERWOOD
Active
Individual
STACY UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
074959
NY
163W00000X
Registered Nurse
5
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP3830
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F401243-1
NY
Other
Enumeration date
08/21/2006
Last updated
07/09/2012
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